- City of New York (New York, NY)
- …lien re-payment. OLR/OLT is recruiting for (1) one Supervisor of Nurses to function as a Complex Medical Case Reviewer , who will: - Conduct medical ... to calculate injury related Medicaid liens pursuant to SSL-104b on cases involving Medical malpractice, mass medical torts, lead paint poisoning, traumatic brain… more
- Mount Sinai Health System (New York, NY)
- …on units as warranted. + Meets with Case Managers, as warranted, to review medically complex and long-stay cases; refer to physician advisor as indicated. + ... + Attends interdisciplinary rounds as necessary. + Meets with Case Managers to review medically complex...Sinai Health System is one of the largest academic medical systems in the New York metro area, with… more
- Mount Sinai Health System (New York, NY)
- …Requirements** + Previous experience as in homecare, long term care or utilization review preferred. + Discharge Planner or Case Manager preferred. + Manager ... Reviews all new admissions to identify patients where utilization review , discharge planning, and/or case management will...Supports the mission, vision, philosophy and goals of the Medical Center. + Promotes an environment that is sensitive… more
- Mount Sinai Health System (New York, NY)
- …on units as warranted. 2. Meets with Case Managers, as warranted, to review medically complex and long stay cases; refer to physician advisor as indicated. ... 10. Attends interdisciplinary rounds as necessary. 11. Meets with Case Managers to review medically complex...Sinai Health System is one of the largest academic medical systems in the New York metro area, with… more
- Mount Sinai Health System (New York, NY)
- **Job Description** The Case Manager is responsible for all aspects of case management/ utilization review for an assigned group of inpatients, ED patients ... specified timeframes. * Reviews all new admissions to identify patients where utilization review , discharge planning, and/or case management will be needed using… more
- Mount Sinai Health System (New York, NY)
- …Masters preferred. + Previous experience as in homecare, long term care or utilization review preferred. + Discharge Planner or Case Manager preferred. + Manager ... Reviews all new admissions to identify patients where utilization review , discharge planning, and/or case management will...Supports the mission, vision, philosophy and goals of the Medical Center. 6. Promotes an environment that is sensitive… more
- Mount Sinai Health System (New York, NY)
- **Job Description** The Director of Case Management is responsible for the overall operation of the Case Management Department. This includes oversight of daily ... care to patients. This involves the delivery of comprehensive front-line Case Management services, including utilization management, care facilitation and discharge… more
- Travelers Insurance Company (Melville, NY)
- …investigating, evaluating, reserving, negotiating and resolving assigned serious and complex Specialty claims. Provides quality claim handling throughout the claim ... of policy information to facts or allegations of each case . + Work with Manager on use of Claim...as policyholders, accounts, claimants, law enforcement agencies, witnesses, agents, medical providers and technical experts to determine the extent… more
- Travelers Insurance Company (Melville, NY)
- …investigating, evaluating, reserving, negotiating and resolving assigned serious and complex General Liability claims. Provides quality claim handling throughout the ... with insured based on application of policy information to facts or allegations of each case . + Consult with Manager on use of Claim Coverage Counsel as needed. +… more
- Nuvance Health (Norwalk, CT)
- …in Connecticut, and Northern Dutchess Hospital, Putnam Hospital Center and Vassar Brothers Medical Center in New York - plus multiple primary and specialty care ... between emergency services, surgical services, nursing, finance, physicians, utilization review and Health Information Management to ensure appropriate level of… more
- Mount Sinai Health System (New York, NY)
- …1-3 years related administrative or business experience Non-Bargaining Unit, BGG - Case Management - STL, Mount Sinai St. Luke's **Responsibilities** 1. Develop and ... quality and timeliness of data 9. Manages data through review , computerization, cleaning and auditing for compliance with standard...Sinai Health System is one of the largest academic medical systems in the New York metro area, with… more
- City of New York (New York, NY)
- …medical accommodations - Supervision of administrative physicians assigned to review medical accommodations - Completes Accommodation Reviews (Home ... Job Description City Medical Specialist II / Complex Care...needs at school - Reviews and assists with in-school case management - Manages complex clinical cases… more
- Mount Sinai Health System (New York, NY)
- … medical leadership when appropriate + Documents authorization review for medical and pharmacy claims. + Prepares case reports, summaries, or other ... in the area of nursing practice assigned; in this case , acute care utilization review . + Previous...to modify and/or add necessary services. + Performs continuing review of medical records; analyzing data trends… more
- Citigroup (New York, NY)
- **Job Description:** Enterprise Change Review and Business Engagement Director **Locations:** NY, Miami, Tampa, Jacksonville, or Irving The Enterprise Change ... drive management reporting and metrics, and define change management requirements. The Change Review and Business Engagement Lead is a new role that will provide… more
- Mount Sinai Health System (New York, NY)
- …with the physician and shall reflect accepted standards of nursing and medical practice. Protocols shall include provisions for case management including ... in the specific clinical area and performs a periodic review of the collaborative agreement. b. Assesses the health...Documents findings and plan of care in the patient's medical record. f. Consults with physician as established in… more
- VNS Health (Manhattan, NY)
- …for utilization review and decision making. + Leads in establishing medical policies for VNS Health Plans; collaborates in the design and implementation of ... OverviewEmbark on a dynamic journey as the Medical Director at VNS Health Plans, where every...advanced care/ case management strategies; and communicates, with providers to ensure… more
- Mount Sinai Health System (New York, NY)
- …- FT Days M-F 8AM-4PM** The Coding Specialist III is responsible for the review and coding of complex inpatient and/or ambulatory surgery records utilizing ... is utilized for reimbursement, clinical care assessment, education, research, case mix and health care statistical reporting. **Qualifications** **Education… more
- VNS Health (Manhattan, NY)
- …components related to requests for services which includes a clinical record review and interviews with members, clinical staff, medical providers, ... outpatient and inpatient admission; approves services or consults with medical directors when case does not meet...two years acute inpatient hospital experience in chronic or complex care required + Must have experience and qualifications… more
- Mount Sinai Health System (New York, NY)
- …Advancing medicine. Healing made personal. **_Roles & Responsibilities:_** Responsible for the review and coding of complex inpatient and/or ambulatory surgery ... is utilized for reimbursement, clinical care assessment, education, research, case mix and health care statistical reporting. Duties and...Sinai Health System is one of the largest academic medical systems in the New York metro area, with… more
- City of New York (New York, NY)
- …ADC in overseeing their Medicaid program areas. The Project Coordinator manages the Case Review process designed to implement error reduction initiatives across ... IN THE PRINCIPLE ADMINISTRATIVE ASSOCIATE CIVIL SERVICE TITLE. The Medical Assistance Program (MAP) administers public health insurance programs,...- Attend with or represent the MAP ADC in Case Review meetings conducted monthly by Program… more